Toxicity of combined treatment of adjuvant irradiation and interferon alpha2b in high-risk melanoma patients

Melanoma Res. 2007 Oct;17(5):304-9. doi: 10.1097/CMR.0b013e3282c3a6ed.


Surgically resected stage III melanoma patients commonly receive adjuvant therapy with interferon (IFN) alpha2b. For those patients with high-risk features of draining node recurrence, radiation therapy can also be considered as a treatment option. The purpose of this retrospective study was to assess the efficacy and radiation-related toxicity of this combined therapy. Eighteen patients receiving adjuvant IFNalpha2b therapy during radiation therapy, or within 1 month of its completion, were reviewed retrospectively and analysed for outcome. Radiation was delivered at 600 cGy dose per fraction, in 16 out of 18 patients, twice a week, and at 200 cGy dose per fraction in two patients five times a week. Total radiation dose and number of fractions were as follows: 30 Gy/5 fr (n=8), 36 Gy/6 fr (n=8) and 50 Gy/25 fr (n=2). The percentage of disease-free patients, with no local recurrence, at 3 years was 88%. In 10 patients, IFNalpha2b was administered concurrently with radiotherapy; in three, within 30 days before or after radiation; and in five, more than 30 days after radiation. All the patients experienced acute skin reactions, grade I on the Radiation Therapy Oncology Group (RTOG) scale. Late radiation-related toxicity was seen in one patient with grade III (RTOG) skin reaction and two with grade IV (RTOG) radiation-induced myelitis. Concurrent use of adjuvant radiotherapy and IFNalpha2b might enhance radiation-induced toxicity, and special care should be taken when the spinal cord is included in the radiation field.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hutchinson's Melanotic Freckle / drug therapy
  • Hutchinson's Melanotic Freckle / radiotherapy
  • Hutchinson's Melanotic Freckle / secondary
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Lymphatic Metastasis
  • Male
  • Melanoma / drug therapy*
  • Melanoma / radiotherapy*
  • Melanoma / secondary
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Recombinant Proteins
  • Retrospective Studies
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology
  • Skin Neoplasms / radiotherapy


  • Antineoplastic Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins